The Effectiveness of 12-Week Greek Traditional Dances Training for Improving Postmenopausal Women Cardiorespiratory Fitness

Keywords: elderly, aerobic exercise, cardiopulmonary performance, functional capacity


The purpose of the present study was to examine the effectiveness of 12-week Greek traditional dances training for improving postmenopausal women cardiorespiratory fitness. Twenty three postmenopausal women, aged 55-68 years, were, randomly, chosen and separated to an experimental group (n=13) that attended a 12-week Greek traditional dances program at a frequency of three sessions per week, 50 minutes each, and a control group (n=10) that continued their daily habits for the same period. Cardiorespiratory fitness was assessed by the six-minute walking test (6MWT) and resting heart rate (HR). For data analysis, the non-parametric test Wilcoxon and Mann-Whitney U test, and Pearson correlation of the SPSS ver. 20.0 for windows was used. No significant difference in the baseline measures was detected between the two groups. After the intervention program it was found out a significant decrease in resting HR (z=-2.50, p<0.05) for the experimental group, but an increase for the control group. A significant increase in distance travelled during the 6MWT (z=-3.18, p<0.01) was observed in the experimental group, while the control group presented a significant decrease (z=-2.49, p<0.05). The results provide evidence for the effectiveness of Greek traditional dances programs in improving the cardiorespiratory fitness of postmenopausal women.


1. Adiputra, N., Alex, P., Sutjana, D.P., Tirtayasa, K., Manuaba, A. (1996). Balinese dance exercises improve the maximum aerobic capacity. Journal of Human Ergology, 25: 25-29.
2. American Heart Association. (2011). Effectiveness-based guidelines for the prevention of cardiovascular disease in women-2011. Journal of the American College of Cardiology, 57(12): 1404-1423.
3. American Heart Association. (2014). Heart disease and stroke statistics. Update, A report from the American Heart Association. Circulation, 129: 28-292.
4. American Thoracic Society (2002). Statement (2002): Guidelines for the six-minute walk test. Am J Respir Crit Care Med, 166: 111-117.
5. Argiriadou, Eir. (2013). The examination of the effects of the participation in Greek dances in perceived health state of adults. Doctoral Dissertation, University of Peloponnesos, Department of Sports Organization & Management, Greece (in Greek).
6. Argiriadou, Eir., Mountakis, C., Konstadinakos, P., Zakas, A., Mavrovouniotis, F., Mavrovounioti, Chr. (2013). The effect of a single bout of Greek dances on subjective health of middle-aged people. Journal of Physical Education and Sport (JPES), 13(2): 177-183.
7. Argiriadou Eir., Mavrovouniotis F., Mavrovouniotis A., Mavrovounioti Ch., Nikitaras N., Mountakis C. (2017). Greek traditional dances program and self-evaluated effects and changes in life. World Journal of Research and Review, 5(6): 19-24.
8. Arts Council England (2006). Dance and Health, the benefits of people of all ages.
9. Asikainen, T.M., Miilunpalo, S., Kukkonen-Harjula, K., Nenonen, A., Pasanen, M., Rinne, M., Uusi-Rasi, K., Oja, P., Vuori, I. (2003) Walking trials in postmenopausal women: effect of low doses of exercise and exercise fractionization on coronary risk factors. Scand J Med Sci Sports, 13: 284-292.
10. Barr, R.G., Wentowski, C.C., Grodstein, F., Somers, S.C., Stampfer, M.J., Schwartz, J., Speizer, F.E., Camargo, C.A.Jr. (2004). Prospective study of postmenopausal hormone use and newly diagnosed asthma and chronic obstructive pulmonary disease. Arch Intern Med, 164(4): 379-386.
11. Bird, S., Radermacher, H., Feldman, S., Sims, J., Kurowski, W., Browning, C., Thomas, S. (2009). Factors influencing the physical activity levels of older people from culturally-diverse communities: an Australian experience. Ageing and Society, 29(8): 1275-1294.
12. Blackman, L., Hunter, G., Hilyer, J., Harrison, P. (1988). The effects of dance team participation on female adolescent physical fitness and self-concept. Adolescence, 23: 437-448.
13. Blumenthal, J., Matthews, K., Fredrikson, M., Rifai, N., Schniebolk, S., German, D., Steege, J., Rodin, J. (1991). Effects of exercise training on cardiovascular function and plasma lipid, lipoprotein and apolipoprotein concentrations in premenopausal and postmenopausal women. Arteriosclerosis, Thrombosis & Vascular Biology, 11(4): 912-917.
14. Borghi-Silva, A., Arena, R., Castello, V., Simões, R.P., Martins, L.E., Catai, A.M., Costa, D. (2009). Aerobic exercise training improves autonomic nervous control in patients with COPD. Respir Med, 103: 1503-1510.
15. Butland, R.J,, Pang, J., Gross, E.R., Woodcock, A.A., Geddes, D.M. (1982). Two-, six-, and 12-minute walking tests in respiratory disease. Br Med J (Clin Res Ed), 284(6329): 1607-1608.
16. Denazi, E., Mavrovouniotis, F., Kouidi, E., Deligiannis, A., Argiriadou, Eir. (2013). The effect of a Greek traditional dances program on functional capacity in elderly women. Sport- und Präventivmedizin, 43(1): 6-11.
17. Diakoumakou, O., Diakoumakos, N. (2010). Menopause and lipid metabolism. Cardiological Opinion, 5(2): 79-83 (in Greek).
18. Durmuş, D., Alayli, G., Uzun, O., Tander, B., Cantürk, F., Bek, Y., Erkan, L. (2009). Effects of two exercise interventions on pulmonary functions in the patients with ankylosing spondylitis. Joint Bone Spine, 76: 150-155.
19. Edwards, B., Li, J. (2013). Endocrinology of menopause. Periodontology 2000, (61): 177-194.
20. Elisaf, M., Pitsavos, Chr., Lymperopoulos, E., Giomalos, K., Athyros, V. (2014). Revised guidelines of the Hellenic Society for Atherosclerosis for the diagnosis and treatment of dyslipidaemias - 2014. Hellenic Review of Atherosclerosis, 5(3): 151-163 (in Greek).
21. Enright, P., Sherill, D. (1998). Reference equations for the Six-minute walk in healthy adults. Am J Respir Crit Care Med, 158: 1384-1387.
22. Eyigor, S., Karapolat, H., Durmaz, B., Ibisoglu, U., Cakir, S. (2009). A randomized controlled trial of Turkish folklore dance on the physical performance, balance, depression and quality of life in older women. Arch Gerontol Geriatr, 48: 84-88.
23. Farrel, S., Braun, L., Barlow, C., Cheng, Y., Blair, S. (2002). The relation of body mass index, cardiorespiratory fitness, and all-cause mortality in women. Obes Res, 10(6): 417-423.
24. Grant, S., Corbett, K., Todd, K., Davies, C., Aitchison, T., Mutrie, N., Henderson, Β., Dargie, Ε. (2002). A comparison of physiological responses and rating of perceived exertion in two models of aerobic exercise in men and women over 50 years of age. British Journal of Sports Medicine, 36(4): 276-281.
25. Green, J., Stanforth, P., Rankinen, T., Leon, A., Rao, D., Skinner, J., Bouchard, C., Wilmore, J. (2004). The effects of exercise training on abdominal visceral fat, body composition, and indicators of the metabolic syndrome in postmenopausal women with and without estrogen replacement therapy. The HERITAGE Family Study Metabolism, 53(9): 1192-1196.
26. Haddock, B., Hopp, H., Mason, J., Blix, G., Blair, S. (1998). Cardiorespiratory fitness and cardiovascular disease risk factors in postmenopausal women. Medicine & Science in Sports & Exercise, 30(6): 893-898.
27. Haddock, B., Marshak, H., Mason, J., Blix, G. (2000). The effect of hormone replacement therapy and exercise on cardiovascular disease risk factors in postmenopausal women. Sports Med Jan, 29(1): 39-49.
28. Hagner, W., Hagner-Derengowska, M., Wiacek, M., Zubrzycki, I. (2009). Changes in level of VO2max, blood lipids, and waist circumference in the response to moderate endurance training as a function of ovarian aging. Menopause: The Journal of The North American Menopause Society, 16(5): 1009-1013.
29. Hallal, P.C., Andersen, L.B., Bull, F.C., Guthold, R., Haskell, W., Ekelund, U. (2012). Global physical activity levels: surveillance progress, pitfalls, and prospects. The Lancet, 380 (9838): 247-257.
30. Halverstadt, A., Phares, D., Wilund, K., Goldberg, A., Hagberg, J. (2007). Endurance exercise training raises high-density lipoprotein cholesterol and lowers small low-density lipoprotein and very low-density lipoprotein independent of body fat phenotypes in older men and women. Metabolism Clinical & Experimental, 56: 444-450.
31. Haskell, W.L., Blair, S.N., Hill, J.O. (2009). Physical activity: Health outcomes and importance for public health policy. Preventive Medicine, 49(4): 280-282.
32. Hopkins, D.R., Murrah, B., Hoeger, W.W., Rhodes, R.C. (1990). Effect of low-impact aerobic dance on the functional fitness of elderly women. The Gerontologist, 30: 189-192. doi:10.1093/geront/30.2.18
33. Hu, F.B., Willett, W.C., Li, T., Stampfer, M.J., Colditz, G.A., Manson, J.E. (2004). Adiposity as compared with physical activity in predicting mortality among women. The New England Journal of Medicine, 351: 2694-2703.
34. Hui, E., Chui, B.T., Woo, J. (2009). Effects of dance on physical and psycho-logical well-being in older persons. Arch Gerontol Geriatrics, 49(1): 45-50.
35. Hwang, P.W., Braun, K.L. (2015). The effectiveness of dance interventions to improve older adults’ health: A systematic literature review. Altern Ther Health Med., 21(5): 64-70.
36. International Sport and Culture Association (2015). The economic cost of physical inactivity in Europe. Retrieved from: Economic Costs of Physical Inactivity in Europe (June 2015).pdf
37. Janyacharoen, T., Laophosri, M., Kanpittaya, J., Auvichayapat, P., Sawanyawisuth, K. (2013). Physical performance in recently aged adults after 6 weeks traditional Thai dance: a randomized controlled trial. Clin Interv Aging, 8: 855-859.
38. Janyacharoen, T., Phusririt, C., Angkapattamakul, S., Hurst, C.P., Sawanyawisuth, K. (2015). Cardiopulmonary effects of traditional Thai dance on menopausal women: a randomized controlled trial. J Phys Ther Sci, 27(8): 2569-2572.
39. Judge, J.A. (2003). Balance training to maintain mobility and prevent disability. American Journal of Preventive Medicine, 25(3 Suppl. 2): 150-156.
40. Karolkiewicz, J., Michalak, E., Pospieszna, B., Deskur-Smielecka, E., Nowak, A., Pilaczynska-Szczesniak, K. (2009). Response of oxidative stress markers and antioxidant parameters to an 8-week aerobic physical activity program in healthy, postmenopausal women. Archives of Gerontology & Geriatrics, 49: 67-71.
41. Kattenstroth, J.C., Kalisch, T., Kolankowska, I., Dinse, H.R. (2011). Balance, sensorimotor, and cognitive performance in long-year expert senior ballroom dancers. J Aging Res, 10: e176709. doi: 10.4061/2011/176709.
42. Kelley, G., Kelley, K., Tran, Z. (2004). Aerobic exercise and lipids and lipoproteins in women: a meta-analysis of randomized controlled trials. J Womens Health (Larchmt), 13(10): 1148-1164.
43. King, Α. (2001). Interventions to promote physical activity by older adults. Journals of Gerontology, 56A(Special Issue II): 36-46.
44. King, A., Haskell, W., Young, D., Oka, R., Stefanick, M. (1995). Long-term effects of varying intensities and formats of physical activity on participation rates, fitness, and lipoproteins in men and women aged 50 to 65 years. Circulation, 91: 2596-2604.
45. King, M.B., Whipple, R.H., Gruman, C.A., Judge, J.O., Schmidt, J.A., Wolfson, L.I. (2002). The performance enhancement project: improving physical performance in older persons. Arch. Phys. Med. Rehabil., 83: 1060-1069.
46. Knopp, R. (2002). Risk factors for coronary artery disease in women. Am J Cardiol, 89: 28-35.
47. Kolovou, G., Bilianou, H. (2008). Influence of aging and menopause on lipids and lipoproteins in women. Angiology, 59(suppl 2): 54-57.
48. Korshoj, M., Lidegaard, M., Krustrup, P., Jorgensen, M.B., Sogaard, K., Holtermann, A. (2016). Long term effects on risk factors for cardiovascular disease after 12-months of aerobic exercise intervention - A worksite RCT among cleaners. PLOS ONE, 11(8): 1-22. Retrieved from
49. Lindheim, S., Notelovitz, M., Feldman, E., Larsen, S., Khan, F., Lobo, R. (1994). The independent effects of exercise and estrogen on lipids and lipoproteins on postmenopausal women. Obstetrics & Gynecology, 83: 167-172.
50. Lin, X., Zhang, X., Guo, J., Roberts, C.K., McKenzie, S., Wu, W.C., Liu, S., Song, Y. (2015). Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials. Journal of the American Heart Association, 4: 1-28. doi: 10.1161/JAHA.115.002014
51. Machacova, K., Vankova, H., Volicer, L., Veleta, P., Holmerova, I. (2015). Dance as prevention of late life functional decline among nursing home residents. Journal of Applied Gerontology: 1-18. doi: 10.1177/0733464815602111.
52. Maciaszek, J., Osiński, W. (2010). The effects of tai chi on body balance in elderly people-a review of studies from the early 21st century. Am J Chin Med, 38: 219-229.
53. Makrilakis, K., Panagiotakos, D., Pitsavos, Chrysohoou, C., Ioannidis, I., Dimosthenopoulos, C., Toutouzas, P., Stefanadis, C., Katsilambros, N. (2004). The association between physical activity and the development of acute coronary syndromes in diabetic subjects (the CARDIO2000 II study). European Journal of Cardiovascular Prevention & Rehabilitation, 11: 298-303.
54. Mavroudi, M., Mavroudi, E., Vavilis, T. (2010). Menopause and atherosclerosis Hellen Obstet Gynecol, 22(4): 143-147 (in Greek).
55. Mavrovouniotis, A., Argiriadou, Eir., Mavrovouniotis, F., Mavrovounioti, Chr., Mountakis, C., Nikitaras, N., Deligiannis, A. (2016). The evaluation of physical health of elderly participants or non-participants in a Greek dances program. Journal of Physical Education and Sport (JPES), 16 Supplement issue (1), Art 116: 713-719.
56. Mavrovouniotis, F., Argiriadou, Eir. (2008). Dance, old people and psychosomatic health. Inquiries in Sport & Physical Education, 6(2): 222-231.
57. Mavrovouniotis, F., Argiriadou, Eir., Papaioannou, Chr. (2010). Greek traditional dances and quality of old people’s life. Journal of Bodywork & Movement Therapies, 14(3): 209-218.
58. Mensink, G., Deketh, M., Mul, M., Schuit, A., Hoffmeister, H. (1996). Physical activity and its association with cardiovascular risk factors and mortality. Epidemiology, 7(4): 391-397.
59. Mora, S., Cook, N., Buring, J., Ridker, P., Lee, I-M. (2007). Physical activity and reduced risk of cardiovascular events: Potential mediating mechanisms. Circulation, 116(19): 2110-2118.
60. North American Menopause Society, (2010). Estrogen and progestogen use in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause, 17(2): 242-255. doi: 10.1097/gme.0b013e3181d0f6b9.
61.Oguma, Υ., Shinoda-Tagawa, Τ. (2004). Physical activity decreases cardiovascular disease risk in women: review and meta-analysis. American Journal of Preventive Medicine, 26(5): 407-418.
62. Palacios, S., Henderson, V., Siseles, N., Tan, D., Villaseca, P. (2010). Age of menopause and impact of climacteric symptoms by geographical region. Climacteric, 13: 419-428.
63. Papaioannou, Chr., Argiriadou, Eir., Mavrovouniotis, F. (2009/2010). The effect of Greek traditional dances on elderly women’s well-being. Woman and Sports, 7: 25-38 (in Greek).
64. Real, F.G., Svanes, C., Omenaas, E.R., Antò, J.M., Plana, E., Jarvis, D., Janson, C., Neukirch, F., Zemp, E., Dratva, J., Wjst, M., Svanes, K., Leynaert, B., Sunyer, J. (2008). Lung function, respiratory symptoms, and the menopausal transition. J Allergy Clin Immunol, 121: 72-80.
65. Rikli, R., Jones, C.J. (2012). Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years. The Gerontologist, 53(2): 255-267.
66. Rodrigues-Krause, J., Farinha, J.B., Krause, M., Reischak-Oliveira, A. (2016). Effects of dance interventions on cardiovascular risk with ageing: Systematic review and meta-analysis. Complementary Therapies in Medicine, 29: 16-28.
67. Roussel, M., Garnier, S., Lemoine, S., Gaubert, I., Charbonnier, L., Auneau, G., Mauriege, P. (2009). Influence of a walking program on the metabolic risk profile of obese postmenopausal women. Menopause: The journal of the North American Menopause Society, 16(3): 566-575.
68. Rousseau, M.E. (1998). Women’s Midlife Health Reframing Menopause. Journal of Nurse-Midwifery, 43(3): 208-223.
69. Seals, D., Hurley, B., Schultz, J., Hagberg, J. (1984). Endurance training in older men and women II. Blood lactate response to submaximal exercise. J Appl Physiol Respir Environ Exerc Physiol, 57(4): 1030-1033.
70. Se-Hong, K., Minjeong, K., Yu-Bae, A., Hyun-Kook, L., Sung-Goo, K., Jung-hyoun, C., Seo-Jin, P., Sang-Wook, S. (2011). Effect of dance exercise on cognitive function in elderly patients with metabolic syndrome: A pilot study. J Sports Sci Med, 10(4): 671-678.
71. Shanahan, J., Coman, L., Ryan, F., Saunders, J., O'Sullivan, K., Bhriain, O.N., Clifford, A.M. (2016). To dance or not to dance? A comparison of balance, physical fitness and quality of life in older Irish set dancers and age-matched controls. Public Health, 141: 56-62,
72. Shimamoto, H., Adachi, Y., Takahashi, M., Tanaka, K. (1998). Low impact aerobic dance as a useful exercise mode for reducing body mass in mildly obese middle-aged women. Journal of Physiological Anthropology, 17: 109-114.
73. Solway, S., Brooks, D., Lacasse, Y., Thomas, S. (2001). A qualitative systematic overview of the measurement properties of functional walk tests used in the cardiorespiratory domain. Chest, 119: 256-270.
74. Swisher, A., Goldfarb, A. (1998). Use of the Six-minute walk/run test to predict peak oxygen consumption in older adults. Cardiopulm Phys Ther J, 9: 3-5.
75. Thompson, P.D., Buchner, D., Pina, I.L., Balady, G.J., Williams, M.A., Marcus, B.H., Berra, K., Blair, S.N., Costa, F., Franklin, B., Fletcher, G.F., Gordon, N.F., Pate, R.R., Rodriguez, B.L., Yancey, A.K., Wenger, N.K. (2003). Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: A Statement from the Council on Clinical Cardiology. Circulation, 107: 3109-3116.
76. Vincent, K.R., Braith, R.W., Felman, R.A., Magyari, P.M., Cutler, R.B., Persin, S.A., Lennon, S.L., Gabr, A.H., Lowenthal, D.T. (2002). Resistance exercise and physical performance in adults aged 60 to 83. J. Am. Geriatr. Soc., 50: 1100-1107.
77. Vryonidou, A., Klonaris, N. (2010). Menopause transition: pathophysiology, symptomatology and treatment. Proceedings of postgraduate courses, Intensive training in endocrinology: 13th cycle-gonads, pp. 251-262. Retrieved from (in Greek).
78. WHO-World Health Organization (2010). Global recommendations on physical activity for health. Geneva, World Health Organization, 2010. Retrieved from:
79. WHO-World Health Organization (2011). Global status report on noncommunicable diseases 2010. Geneva, World Health Organization, 2011. Retrieved from:
80. WHO-World Health Organization (2014). Noncommunicable Diseases (NCD) Country Profiles, 2014. Retrieved from:
81. Zapantis, G., Santoro, N. (2003). The menopausal transition: characteristics and management. Best Practice & Research Clinical Endocrinology & Metabolism, 17(1): 33-52.
82. Zhang, J.G., Ishikawa-Takata, K., Yamazaki, H., Morita, T., Ohta, T. (2008). Postural stability and physical performance in social dancers. Gait Posture, 27: 697-701.